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SUMMARY:Most cardiovascular risk prediction equations need to be updated o
 r replaced - Prof Rod Jackson\, Auckland\, New Zealand
DTSTART:20170918T120000Z
DTEND:20170918T130000Z
UID:TALK82131@talks.cam.ac.uk
CONTACT:Katja Kivinen
DESCRIPTION:The majority of cardiovascular disease (CVD) risk prediction e
 quations are derived from cohorts established last century that included p
 articipants at higher risk\, on less treatment and who were less socio-eco
 nomically and ethnically diverse\, than patients the equations are now app
 lied to. \n\nThe validity of most of these equations is uncertain\, largel
 y because the relevant cohorts required to evaluate them are rare. Approxi
 mately 90% of middle-aged New Zealanders have had quantitative CVD risk as
 sessments using a Framingham Heart Study equation (FHSE)\, since risk asse
 ssment was made a national primary healthcare priority in 2008. We piggyba
 cked on this initiative to recruit a nationally representative primary car
 e cohort to: i. assess the validity of the 2013 Pooled Studies equations (
 PCEs) that recently replaced FHSEs in the US and elsewhere\; and ii. devel
 op new equations if justified.\n\nWe demonstrate that a contemporary cohor
 t representing typical patients that prediction equations are applied to\,
  can be recruited using decision support integrated with routine linked el
 ectronic patient records. We show that new US risk prediction equations su
 bstantially overestimate observed CVD risk and this is not explained by ne
 w drug treatment. Recalibration would be insufficient to improve the perfo
 rmance of the PCEs and simple variables representing common ethnicities an
 d socio-economic deprivation should be incorporated into current equations
 . \n\nNew equations are provided that could be implemented in the 15-20 hi
 gh-income countries with relatively similar CVD events rates and healthcar
 e systems to New Zealand.
LOCATION:Seminar Room\, Strangeways Research Laboratory
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